UHF established the Medicaid Institute in 2005 to provide information and analyses examining New York’s Medicaid program and to help all stakeholders build a more effective health care system for low-income New Yorkers.
How Medicaid Supports New Yorkers
Medicaid provides a broad range of health care services to a diverse group of New Yorkers. The program’s responsibilities include three main roles:
- Providing health insurance to low-income children and adults
- Covering people with disabilities who have no other access to services
- Supplementing Medicare for low-income elderly and people with disabilities
Medicaid covered more than 6 million New Yorkers in any given month of 2018, with $72.4 billion in total expenditures during State Fiscal Year (SFY) 2019.1 Between SFY 2012 and SFY 2019, average enrollment increased by more than 24 percent, while average per-enrollee expenditures increased by eight percent.2,3 As of December 2018, children under age 21 accounted for 37 percent of total enrollment, with Medicaid covering approximately 45 percent of all children in New York and financing 51 percent of the state’s births in 2017.4 Adults age 65 and over made up 12 percent of total enrollment in December 2018, and 15 percent of Medicaid members were dually eligible for both Medicare and Medicaid as older adults or non-elderly individuals with disabilities.5
The program is currently undergoing a substantial shift in how services are provided and paid for. Reforms envisioned by Governor Cuomo’s Medicaid Redesign Team in 2011 led to a large increase in the number of members and extent of health care services covered by managed care organizations. As of December 2018, about 78 percent of Medicaid members were enrolled in some form of managed care.6
Additionally, in 2014 the State began implementing a Medicaid waiver from the federal government that allowed it to reinvest $8 billion of savings from the Medicaid Redesign Team’s reform efforts. This waiver was intended to transform how care is delivered through the Delivery System Reform Incentive Payment (DSRIP) program and how services are paid for through a roadmap to value-based payment, yielding a number of promising practices identified by UHF’s Medicaid Institute that may facilitate future delivery system reforms and broader progress toward value-based payment.
How UHF Is Helping Improve Medicaid
As an independent source of information and analysis, United Hospital Fund’s Medicaid Institute partners with the New York State Department of Health and other stakeholders to improve the Medicaid program in three ways:
- Producing analyses and other information to shape discussions of Medicaid policy and implementation
- Convening and engaging stakeholders to inform policy analyses, disseminate knowledge, identify best practices, and discuss policy and operational opportunities and challenges
- Facilitating and managing specific policy development and review processes
Through these activities, the UHF Medicaid Institute informs policymakers and the public on key Medicaid issues and helps strengthen the program, which is a vital source of coverage and health care for vulnerable New Yorkers.
Contact: Nathan Myers